Kuang YaShu, Li Xiaolin, Chen Xiaoli, Sun Huimin, Tomlinson Brian, Chan Paul, Zheng Liang, Pi Jinjiang, Peng Sheng, Wu Hong, Ding Xugang, Qian Dingguang, Shen Yixin, Yu Zuoren, Fan Lieying, Chen Ming, Fan Huimin, Liu Zhongmin, Zhang Yuzhen
Research Center for Translational Medicine, Key Laboratory of Arrhythmias, Ministry of Education, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
Sci Rep. 2016 Sep 30;6:34268. doi: 10.1038/srep34268.
Lipid levels are increasing in all age groups in the Chinese population, but the use of statin treatment in the elderly is not well documented. We examined serum lipids, statin usage and achievement of lipid goals in 3950 subjects aged ≥65 years. Established CVD was present in 7.77% of participants and increased CVD risk was common. Elevated LDL-C according to CVD risk level was present in 46.70% of all subjects and was more frequent (p < 0.01) than elevated non-HDL-C at 32.58%. With increasing age, LDL-C was unchanged but triglycerides and non-HDL-C decreased and HDL-C increased. Individuals at moderate risk for CVD had higher TC, LDL-C, and non-HDL-C than low-risk subjects, but the values were lower in high- and very-high-risk individuals, probably because of the use of statin which was 28.57% in high-risk subjects with established CVD and 37.60% in very-high-risk individuals, but only 2.62% in those with estimated high-risk and 3.75% in those with high-risk from diabetes. More subjects in each risk group reached the non-HDL-C goal than the LDL-C goal because of the relatively low triglycerides and VLDL-C levels. These findings demonstrate a high prevalence of elevated LDL-C but low rate of statin treatment in elderly community-dwelling Chinese.
中国人群中各年龄组的血脂水平都在上升,但老年人他汀类药物治疗的使用情况尚无充分记录。我们对3950名年龄≥65岁的受试者进行了血脂、他汀类药物使用情况及血脂目标达成情况的检查。7.77%的参与者存在已确诊的心血管疾病(CVD),且心血管疾病风险增加的情况很常见。根据心血管疾病风险水平,46.70%的所有受试者存在低密度脂蛋白胆固醇(LDL-C)升高,且比非高密度脂蛋白胆固醇(non-HDL-C)升高更为常见(p < 0.01),后者为32.58%。随着年龄增长,LDL-C无变化,但甘油三酯和non-HDL-C下降,高密度脂蛋白胆固醇(HDL-C)升高。心血管疾病中度风险个体的总胆固醇(TC)、LDL-C和non-HDL-C高于低风险个体,但在高风险和极高风险个体中这些值较低,这可能是因为他汀类药物的使用情况:在已确诊心血管疾病的高风险受试者中为28.57%,在极高风险个体中为37.60%,但在估计为高风险的个体中仅为2.62%,在糖尿病高风险个体中为3.75%。由于甘油三酯和极低密度脂蛋白胆固醇(VLDL-C)水平相对较低,各风险组中更多受试者达到了non-HDL-C目标而非LDL-C目标。这些发现表明,在社区居住的中国老年人中,LDL-C升高的患病率很高,但他汀类药物治疗率较低。